Eligibility Counselor I
Change Healthcare
Guaynabo, PR
hace 47 días

This position services to assist low-income Medicare beneficiaries enrolled in a contracted Managed Care Organization Medicare+Choice health plan, with the qualification and recertification process for Medicare Savings Programs. The recertification team

conducts telephonic outreach to remind, assist, and keep the members enrolled by either phone outreach or mailings. This outreach is performed before and around the members’ recertification date.

Responsibilities :

  • Conducts telephonic outreach activities for members who need to recertify and are eligible for the Medicare Savings Programs.
  • May also need to contact the state to properly complete the recertification process.

  • Completes MSP renewal applications if needed for members. Also, insure that applications are completely filled out and every question is answered correctly before the member submits it to the state.
  • Must conduct proper and effective follow up to ensure state renewal applications are sent to the state in a timely manner and Altegra Health documents are received to conduct further assistance.
  • Meets daily, weekly, and monthly production goals. Must also meet quality standards by ensuring proper phone etiquette and adherence to scripts, make accurate and descriptive MMS documentation
  • Participates as required in Altegra Health's staff and operational development programs. Acts as a team player and communicates openly and honestly.
  • Maintains current knowledge of state and federal regulatory requirements to adhere to strict compliance of all aspects Altegra Health's Outreach Operations.
  • Demonstrates behaviors, actions, and attitudes that reflect Altegra Health's vision, mission and values.
  • Performs other duties as assigned.
  • Requirements Qualifications :

  • High School Education; Associates Degree or Bachelors Degree preferred.
  • 2 years experience with direct consumer interaction, telephone sales experience, and Medicaid program experience preferred.

  • Demonstrated application of data entry and related computer skills.
  • Excellent oral communication skills; ability to communicate with elderly individuals and state governmental personnel.
  • Ability to analyze and interpret governmental program criteria; ability to interact and decipher information via telephonic or correspondence inquires.
  • Change Healthcare is an Equal Opportunity Employer. Employment at Change Healthcare is based upon your individual merit and qualifications.

    We don’t discriminate on the basis of race, color, religion, gender, sexual orientation, gender identity or expression,

    national origin, age, physical or mental disability, marital status, protected veteran status or disability, genetic characteristic, or any other characteristic protected by applicable federal, state or local law.

    We will also make all reasonable accommodations

    to meet our obligations under the Americans with Disabilities Act (ADA) and state disability laws. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or

    disability. Please visit Equal Employment Opportunity Posters provided by OFCCP

    here.

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